Inoue Y, Miura N, Watanabe T, Watanabe K, Tsutsumi T, Doutsu Y, Kohno S, Kanda T, Hirota M, Hara K
Department of Internal Medicine, Nagasaki Municipal Medical Center, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Mar;29(3):332-7.
Retrospective studies of pleural biopsy, cytology and ADA in pleural effusion were performed in 116 patients with pleural effusion between 1980 and 1988. Pleural malignant disease was diagnosed in 25 patients (75.8%) by cytology, in 19 patients (57.6%) by pleural biopsy. Thus, cytology should be performed first in patients with pleurisy. Both of cytologic study and CEA in pleural effusion were negative in 3 cases of squamous cell carcinoma. Tuberculous pleuritis was diagnosed in 24 patients (50.0%) by pleural biopsy, in 5 patients (10.4%) by isolation of Mycobacterium tuberculosis. Both pleural biopsy and adenosine deaminase activity (ADA) were examined in 19 cases of tuberculous pleuritis and ADA was elevated in 16 patients (84.2%). These data suggested that pleural biopsy was useful for diagnosis of pleuritis and the combination of cytology, tumor markers and ADA with biopsy improved diagnostic rates of pleuritis.
1980年至1988年间，对116例胸腔积液患者进行了胸腔活检、细胞学检查及胸腔积液中腺苷脱氨酶（ADA）的回顾性研究。通过细胞学检查诊断出25例（75.8%）胸膜恶性疾病，通过胸腔活检诊断出19例（57.6%）。因此，胸膜炎患者应首先进行细胞学检查。3例鳞状细胞癌患者的细胞学检查及胸腔积液中癌胚抗原（CEA）均为阴性。通过胸腔活检诊断出24例（50.0%）结核性胸膜炎，通过分离结核分枝杆菌诊断出5例（10.4%）。对19例结核性胸膜炎患者进行了胸腔活检及腺苷脱氨酶活性（ADA）检测，16例（84.2%）患者ADA升高。这些数据表明，胸腔活检对胸膜炎的诊断有用，细胞学检查、肿瘤标志物及ADA与活检相结合可提高胸膜炎的诊断率。
